Focus, starting, and ADHD

If the deadline is six weeks off and you can really only see three days ahead, do not try to grow the horizon. Move the deadline closer with a checkpoint.

A five minute catch-up with someone every couple of days does more than a beautifully drawn plan for the whole six weeks. In work with little…

When you ask a manager for regular check-ins, ask for them as a way of staying pointed in the right direction. That is a different conversation from asking to be watched.

Something like: could we take five minutes twice a week, so I can be sure I am working on what matters most to you. You are the one proposing it, so…

'It's bad for your health' and 'grades matter later' move nobody, least of all someone who has never seen what either one looks like.

If you want a future to carry any weight, it has to be pictured rather than stated. What does the day look like. Who is in the room. What is…

A consequence has to cost the person whose behaviour it is, in something they actually care about. If missing the bus mildly annoys your teenager and wrecks your morning, the cost is landing on the wrong person.

So move it. A few pounds for the lift, or the phone for the day. Say it plainly beforehand, then do it without the lecture attached. What counts as…

Ask people how it went. How was that meeting, how am I doing, what did you make of it. Nobody enjoys asking, and the information is not available any other way.

Ask one specific person about one specific thing rather than the room in general. If your read on yourself has been bent out of shape by years of…

Someone who will tell you the part that was not good is someone whose 'that was fine' you can believe. That is what settles the doubt, not reassurance.

Blanket praise carries no information, so it slides off and the doubt is back within the hour. If you tend to worry about how you came across, ask…

If the only real deadline is the fortnightly meeting, invent some smaller ones. A couple of short catch-ups a week will do more for the work than the formal review ever does.

Ask for them as something that helps you, because it is true and it also lands better: five minutes on Tuesday and Thursday keeps me pointed at the…

Some people genuinely do not feel time passing. There is now, and there is not now, and the hour in between goes missing. That is a difference in perception rather than a comment on how much someone cares.

Worth saying plainly in a family where lateness has turned into a moral argument. A person who is never on time may be honestly surprised each…

Help lands best at the moment and in the place the behaviour is actually needed. A skill taught in a quiet room on Tuesday rarely turns up in a noisy classroom on Thursday.

Which means the teacher standing there at the time is in the strongest position of anyone, and the parent at the kitchen table is next. Someone…

A school to home report works daily for younger children and weekly for older ones. The point is to close the gap between what happened at school and anything that follows at home.

A young child cannot hold a week of behaviour in mind, so a week later means nothing to them. A teenager can, and daily can feel like surveillance.…

Put behaviours on the report, not grades. Finished the class work, followed the rules, got on with the others, handed the homework in.

A grade is weeks of work, a marking scheme and a bit of luck, and no child can decide on a Tuesday to have a better one. The behaviours underneath it…

Two to four targets is the usual advice and three is plenty. A longer list looks thorough and quietly stops working.

Every extra line is another thing a busy teacher has to notice and rate honestly at the end of a lesson, and another thing the child is meant to hold…

Send the report between the adults, by email or through the school system. Do not make the child carry a piece of paper to four teachers and then home.

Carrying a document around all day, remembering to produce it at the right moments and getting it home in a bag is exactly the sort of thing the…

A report card with nothing attached to it changes nothing. The ratings have to lead somewhere at home, to something earned or not earned that day.

The sheet is only a measurement. What actually shifts behaviour is what follows it, which means the family side is where these plans live or die.…

Early on, reward the work being finished even when it is rough. Accuracy tends to follow once things are getting done at all.

If the reward only arrives for good work, a child who never finishes anything earns nothing, and a plan that pays out nothing stops being a plan. Set…

When a decision is looming, write the options out rather than talking them through. A test is coming: do nothing, make a revision timetable, ask for extra help. Three lines on paper.

Options do not tend to appear by themselves when planning is hard, and holding three of them in mind while weighing them up is harder still. On paper…

Make handed-in homework one of the tracked targets. It is the thing that goes wrong most and the thing worth most when it goes right.

Homework has four separate places to fail: writing down what it is, bringing the right things home, actually doing it, and getting it back the next…

Look in often, say the good bits out loud, and stop for a few minutes about every hour. Three small things that carry more than any talk about concentrating harder.

Checking in supplies the noticing a child cannot yet do for themselves, and it lands better as a passing question than as an inspection. The praise…

When somebody looks like they have stopped caring, it is often that they have stopped expecting it to go well. Giving up on yourself tends to come after a long run of trying and being told it was not enough.

That changes what helps. Another plan, another chart, another talk about wasted potential all land on the wrong problem. What shifts things is a…

When you are the one helping, let the tone stay warm and a little funny. A person can hear a hard truth about their own week if it does not arrive solemnly.

Solemn advice gets defended against and then forgotten, and the moment it is needed is later, alone, with nobody there to repeat it. Something said…

Ask for the old school reports every time. Some people arrive with a folder of every one they ever had, and you cannot tell in advance which people those are.

It is easy to assume that a parent who is disorganised will not have kept anything, and that assumption quietly costs you evidence. Teacher comments…

When you explain executive function to parents and teachers, four words will do: attention, reasoning, speed, memory. Each one can be worked on, and four is a number people can still repeat at the school gate a week later.

The academic models have a dozen headings and nobody outside the field retains them. A short list gives parents something to hang observations on, so…

When a child keeps failing at a task, try reducing what it demands of attention and memory before you increase the practice. Shorter steps, one instruction at a time, the working written down where they can see it.

Attention, holding things in mind and switching between steps all set a ceiling on how much of a lesson gets through. You cannot easily raise that…

Pouring more in does not help while the lid is still on. A child who is exhausted, wound up or not yet settled will keep very little of the lesson, however good the lesson is.

Do the settling first, even when it costs ten minutes of the hour. Sleep, food, movement and a calm start look like the soft part of the day and they…

A child who talks well, listens well and seems bright will have their reading failure read as laziness. The strengths are exactly what makes the blame stick.

Strong spoken language, decent attention and an easy manner give an impression of capability that nobody can square with work coming back unfinished.…

Worry about height is one of the commonest reasons families hesitate. The answer is to measure: height and weight plotted at every review, so you are watching an actual line rather than guessing at one.

Growth speeds up and slows down for all sorts of reasons during the years a child might be medicated, and one measurement tells you almost nothing. A…

If a small child cannot swallow tablets, that is a solvable problem rather than a reason to give up on treatment. One methylphenidate preparation comes as a skin patch.

Children who cannot manage pills often will not say so in words. What you see instead is spitting, hiding, gagging, or a battle every morning. Ask…

People often refuse one name and accept another when both contain the same drug. Ritalin and Concerta are both methylphenidate, delivered differently.

A brand collects a reputation that has nothing to do with the molecule, usually from something somebody said years ago. So ask plainly: what is the…

A child who barely touches lunch may still eat a normal amount across the day. Look at breakfast and dinner before concluding that they are not eating.

The usual pattern is a decent breakfast, very little at midday and a large dinner, with appetite returning as the dose wears off. So make the two…

When a dose that was working seems to stop working in a growing child, check height and weight before you reach for the word tolerance. These medicines are dosed by body weight, and a child can simply have outgrown the dose.

It is the cheaper explanation and the more common one, and it takes a single appointment to test. Bring the growth chart and the dates when you…

An untreated attention difficulty rarely stays a blank space. People tend to find something that steadies them, and what they find is not always kind.

Nicotine, coffee at strange hours, cannabis in the evening, a bit of somebody else's prescription: these are often attempts at self correction rather…

Parents often ask whether starting a stimulant now makes drug problems more likely later. The question deserves the actual evidence, gently given, rather than reassurance.

It is one of the most studied worries in this field, followed in the same children across years instead of guessed at. Say what was looked at and…

Conversations about alcohol and cannabis tend to be timed for the child you expect to have at fourteen. With an attention difficulty in the picture, start them earlier and keep them light.

Early does not mean heavy. It means the subject is already open, so the first offer is not the first mention. Keep the tone curious rather than…

In simulator work the biggest improvements on medication show up in the drivers who were worst without it: stopping properly, slowing for an amber, actually looking around.

That pattern is quietly reassuring. A drug that made everyone sharper would lift the good drivers as well, and this does not look like that. It looks…

Canada once pulled a stimulant from the market after four cardiac deaths, then reversed the decision. Three of the four had heart abnormalities from birth and the fourth had been hiking in desert heat without water.

A handful of deaths with nothing to compare them against cannot tell you what caused them. That is an uncomfortable thing to say about people who…

No behavioural programme matches what medication does to the core symptoms. It is an uncomfortable sentence for anyone who would rather not medicate, and it is what the trials keep showing.

That does not make the rest of the work pointless, and it does change the order things go in. Where someone is drowning, the fastest reliable help…

Public health messages sometimes say parent training works just as well as medication and carries no side effects. Both halves of that are wrong, and a family who believes it can lose a year.

Parent training is genuinely useful and it is hard work, costing time, money, patience and a good deal of household goodwill. Calling it free of side…

Medication belongs in ordinary treatment here rather than at the end of the queue. Most people with a clear diagnosis will use it at some point.

Strategies and accommodations do real work while somebody is watching, and they fall away in the settings where nobody is. That is most of adult…

Nobody is sitting in the passenger seat handing out rewards for safe driving. Medication is the part of treatment that is present when no adult is.

Behavioural plans need somebody to run them. The moments carrying the most risk in adolescence are the ones with nobody there: the drive home, the…

Parents and teachers warm to a plan that includes something they do, rather than a prescription on its own. That is not a scientific argument and it still matters.

People stay with treatment they believe in, and belief rises when they have a part in it. So offering the behavioural piece is doing two jobs at…